Hepatitis panel
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Acute Hepatitis Panel (AHP) aid in the diagnosis of acute viral hepatitis due to infection with hepatitis A virus (HAV), hepatitis B virus (HBV) or hepatitis c virus (HCV) and includes the following test:
Hepatitis is an inflammation of liver resulting from viruses, drugs, toxins, and other etiologies. Most cases of Hepatitis are caused by HAV, HBV and/or HCV. Hepatitis A is caused by infection with HAV, an RNA virus that is classified as picornavirus.
Pathogenesis of Hepatitis A according to CDC includes the following:
a. Fecal- oral transmission
b. Viral replication in the liver
c. Virus present in blood and feces 10-12 days after infection
d. Virus excretion may continue for up to 3 weeks after onset of symptoms
HAV is the most common cause of hepatitis in children and adolescents in the United States. The clinical features for Hepatitis A include the incubation period of approximately 28 days (range 15-50 days). The symptom includes abrupt onset of fever, malaise, anorexia, nausea, abdominal discomfort, dark urine, jaundice. HAV is diagnosed by IgM anti-HAV, which typically appears within four weeks of exposure, and which disappears within three months of its appearance. IgG anti-HAV is similar in the timing of its appearance, but it persists indefinitely. Its detection indicates prior effective immunization or recovery from infection. Virtually, all patients with acute hepatitis A have detectable IgM anti-HAV.
Hepatitis B is a vaccine-preventable liver infection caused by HBV and can range from a mild, short-term, acute illness lasting a few weeks to a serious, long-term, chronic infection. Acute hepatitis B is a short-term illness that occurs within the first 6 months after exposure to HBV. Some people with acute hepatitis B have no symptoms or only a mild illness. For others, acute hepatitis B can cause more severe illness that may require hospitalization and lead to a lifelong infection know as chronic hepatitis B. if left untreated, chronic hepatitis B can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death.
Hepatitis B is primary spread when blood, semen, or certain other blood fluids-even in microscopic amounts from a person infected with HBV enter the body of someone who is not infected. The best way to prevent hepatitis B is by getting vaccinated. CDC recommends all infants, all children and adolescents younger than 19 who have not been vaccinated, adults ages 19-59, and adults age 60 and older at higher risk for hepatitis B to get vaccinated against Hepatitis B.
HBV produces three separate antigens (surface, core, and e(envelope) antigens) when it infects the liver. Essentially, the serological diagnosis of acute HBV infection is established by the hepatitis B virus surface antigen (HBsAg) and anti-hepatitis B core IgM antibody (anti-HBcIgM) detection in serum, sometimes accompanied by the hepatitis B “e” antigen (HBeAg) detection. Hepatitis B surface antigen (HBsAg) is the earlier marker, appearing in serum four to eight weeks after exposure and typically disappearing within 6 months after its appearance. HBsAg assays are routinely used to diagnose suspected HBV infection and monitor the status of infected individuals to determine whether the infection has resolved, or the patient has become a chronic carrier of the virus. In patients that recover from HBV infection, HBsAg is undetectable 3-5 months after the onset of infection. If HBsAg remains detectable for greater than 6 months, this indicates chronic HBV infection. Similarly, Anti-HBc IgM antibodies becomes detectable in the blood stream around 6 weeks after HBV exposure, even during incubation period, and around 1 month after the HBsAg appearance. They usually remain detectable for 2-6 months, peaks during the acute infection stage of HBV infection, and then falls to a relatively low level as the patient recovers or becomes a chronic carrier. Anti-HBc IgM is useful in the diagnosis of acute HBV infection and it’s finding is sufficient for a conclusive diagnosis of acute HBV infection.
Hepatitis C virus is one of the most common types of viral hepatitis in the United States. According to CDC, It is estimated that more than 2.4 million people and as many as 4 million people had hepatitis C from 2017- 2020. The test commonly used to identify current HCV infection includes HCV antibodies and HCV RNA. HCV antibodies usually appear 2-4 months after infection. Detection of both HCV antibody and HCV RNA indicates current HCV infection. Detection of HCV antibody in the absence of HCV RNA is consistent with the absence of current HCV infection. Repeat HCV RNA testing is recommended if the person tested is suspected to have had HCV exposure within the past 6 months or has clinical evidence of HCV disease.
References:
Statement on Medical Necessity
All ordered tests should be medically necessary for the diagnosis or detection of disease, illness, impairment, symptom, syndrome, or disorder and the results should be used in the medical management and treatment decisions for the patient. Solaris requires ICD-10 codes with each order for lab testing and both the tests ordered and the diagnosis should be documented in the provider’s medical record for the patient. The United States Department of Health and Human Services, Office of Inspector General, takes the position that a provider who orders medically unnecessary tests may be subject to civil penalties.
Panels and Profiles
Solaris offers Providers the convenience of ordering test combinations in a group at times with the flexibility to choose appropriate test(s) for individual patients. Providers should only order those tests that he or she believes are medically necessary for each patient, and a lesser inclusive profile or individual tests should be ordered if not all tests in the test combination/profile are medically necessary. All tests offered in a test combination/profile may be ordered separately as individual tests. Solaris encourages clients to contact their Solaris representative if the testing configurations shown do not meet individual needs for any reason, or if some other combination of procedures is needed.
CPT Codes
CPT Codes listed are in accordance with Current Procedural Terminology, a publication of the American Medical Association. CPT codes are the responsibility of the billing party and are listed here for informational purposes. Correct coding may vary from one carrier to another. Solaris may bill specific carriers using codes other than what is shown.
For questions or inquiries related to testing please reach out to
customerservice@solarisdx.com or contact us by phone at (844) 550-0308.
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